112 OUTCOME OF VERY PRETERM SMALL FOR DATE INFANTS

Abstract

Objective: To investigate the effect of intra-uterine growth retardation on mortality and developmental outcome at 5 years of age in a cohort of very preterm infants.Patients and methods: From a national collaborative study of 1338 liveborn infants of < 32 weeks and/or < 1500 grams, 765 infants were selected on gestational age (GA) between 25 and 32 weeks, kaukasian race, and without having congenital malformations. Infants were classified according to Kloosterman's percentiles. Small for gestational age (SGA) infants (< 10th centile) were compared with appropriate for gestational age (AGA) infants (25-75th centile).Results: Neonatal mortality and mortality at 5 years of age is significantly higher in SGA compared with AGA after stratifying for C section or vaginal delivery (OR 0.55 (0.32 - 0.95) p=0.02), a similar result is found after taken into account GA, sex, multiple pregnancy (MPR) as confounders. Overall outcome at 5 year expressed in handicap rate (WHO definition) is not significantly different (SGA 20% vs AGA 13% (p= 0.17)). However, cerebral palsy is less frequent in SGA infants than in AGA infants (7.2% vs 14,9%), while retardation of gross motor skills is more frequent in SGA infants (15.7% vs 7.4%). Mental development, language/speech development and need for special education seems to be worser in SGA infants, but is not statistically significantly different (OR 0.85) after correction for confounders GA, sex, and MPR.Conclusion: Mortality in SGA infants is about twice as high as compared to AGA infants in the first 5 years. Overall developmental outcome in the SGA survivors at 5 year appears not to be different from AGA infants.